Ohio to seek expansion of Medicaid

Feb. 4, 2013
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The Rev. Gayle Catinella, left; David West, center; and Donna Weinberger listen to arguments for Ohio Medicaid expansion at a meeting at Olivet Institutional Baptist Church in Cleveland. More than 1,000 people rallied at the church Jan. 24 to show their support for expanding Medicaid in Ohio. / Thomas Ondrey, The (Cleveland) Plain Dealer

The move positions Ohio among a contingent of Republican-led states including Arizona, Nevada, New Mexico and North Dakota that are leaning toward extending coverage, an option given to states under the federal Affordable Care Act.

"I don't believe in the individual mandate," Kasich said. "But I think that this makes great sense for the state of Ohio."

His contention: If Ohio doesn't extend Medicaid, federal tax dollars will be used to expand health coverage in other states and give businesses elsewhere a competitive advantage by creating a healthier workforce.

Nineteen states and the District of Columbia have said they will participate in Medicaid expansion, according to consulting firm The Advisory Board Co. Five other states are leaning toward participating while 15 states have either decided against the expansion or are leaning that way. The remainder have not committed.

The proposal, now up to Ohio's Republican-dominated legislature to decide, will extend coverage to adults living at 138% of the federal poverty level, or about $32,000 a year for a family of four and $15,400 a year for an individual.

The Medicaid expansion nationwide is intended to cover about half of the 30 million uninsured people expected to gain coverage eventually under the health care overhaul.

Ohio's Medicaid program now covers adults and their dependents at 90% of the federal poverty level and does not cover single individuals or childless adults. A family of four earning $20,745 or less qualifies for current coverage.

As with all states choosing to expand the program, the federal government will cover 100% of the program for three years for the newly qualified individuals. After that, the federal government would cover 95% and phase down to 90%.

Ohio will see $2.4 billion in federal money in the next two years beginning in July to cover those who are newly eligible, the Kasich administration said.

One wrinkle in the governor's proposal: Ohio will roll back the expansion if the federal government changes its commitment.

Medicaid, as it has been in the past, consumes the largest chunk of Ohio's budget with $21.46 billion in spending proposed in 2014 and $23.64 billion in 2015.

If the legislature approves, the extension would be put in place by January 2014.